脱落细胞DNA定量分析在口腔潜在恶性疾病诊断中的准确性  

DNA cytometry of exfoliated cells in the diagnosis of oral potential malignant disorders

作　　者：刘洋[1] 高岩[2] 陈学杰[1] 华红[1] LIU Yang;GAO Yan;CHEN Xue-jie;HUA Hong(Department of Oral Medicine, Beijing 100081, China;Department of Oral and Maxillofacial Surgery, School of Stomatology, Shandong University, Jinan 250012, China)

机构地区：[1]北京大学口腔医学院.口腔医院口腔黏膜科,北京100081 [2]北京大学口腔医学院.口腔医院口腔病理科国家口腔疾病临床医学研究中心口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室,北京100081

出　　处：《北京大学学报（医学版）》2019年第1期16-20,共5页Journal of Peking University:Health Sciences

基　　金：北京大学口腔医学院临床新技术新疗法项目(PKUSSNCT-15A05)~~

摘　　要：目的:探讨口腔黏膜脱落细胞DNA定量分析在筛查口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)及口腔潜在恶性疾病(oral potential malignant disorders,OPMDs)的准确性。方法:对203例口腔黏膜病患者进行组织病理学检查和DNA定量分析检测,以组织病理学检查为金标准,评价DNA定量分析诊断的灵敏度、特异度、Youden指数、阳性似然比、阴性似然比、阳性预测值、阴性预测值等。结果:共纳入组织病理学检查为OSCC和原位癌(tumor in situ,TIS)的患者46例,白斑(oral leukoplakia,OLK)上皮异常增生患者39例,疣状白斑伴基底细胞增生活跃1例,白斑单纯增生29例,口腔扁平苔藓(oral lichen planus,OLP) 83例,炎症5例。以组织病理学诊断结果为金标准,以OSCC、TIS和上皮异常增生为阳性组,其他为阴性组,DNA定量分析系统诊断的灵敏度为79. 07%,特异度为81. 20%,准确度为80. 30%;诊断OSCC和TIS的灵敏度95. 65%,特异度81. 20%,诊断准确度为85. 28%;诊断上皮异常增生时,DNA定量分析系统诊断的灵敏度60. 00%,特异度81. 20%,诊断准确度为75. 8%。结论:DNA定量分析诊断操作微创,简便,可以作为OSCC及OPMDs的筛查方法以及OSCC术后随访的辅助监测手段。Objective: To evaluate the diagnostic efficiency of oral mucosa disease, especially oral squamous cell carcinoma (OSCC) and oral potential malignant disorders (OPMDs) by DNA cytometry compared with histopathological diagnosis, so as to find a convenient, simple and low-invasive method for screening and follow-up. Methods: 203 subjects with OSCC, OPMDs and other oral mucosa disease without dysplasia according to the inclusion criteria and exclusion criteria were recruited from Peking University School and Hospital of Stomatology. The mean age was (52.44±13.55) years, 98 males and 105 females. Brush biopsy was taken before scalpel biopsy at the same site. The brush biopsy sample was screened by moticytometer system for DNA cytometry after Feulgen stain, and histopathological examination were taken for the scalpel tissue. Data from DNA cytometry were used to calculate the parameters, such as sensitivity, specificity, positive and negative predictive values, odds ratios, Youden index (YI), positive and negative likelihood ratios, compared with the golden standard, histopathological diagnosis. DNA cytometry and histopathological diagnosis were performed back to back. Results: Totally, 42 OSCC and 4 tumor in situ (TIS), 39 oral leukoplakia (OLK) with dysplasia (17 mild dysplasia, 13 medium dysplasia and 9 severe dysplasia), 29 OLK with hyperplasia, 1 verrucous OLK, 83 oral lichen planus (OLP) and 5 inflammation were included in our research. We grouped the OSCC, TIS and dysplasia as the positive group and others without dysplasia as the negative group, the sensitivity of DNA cytometry was 79.07%, the specificity was 81.20%, and the diagnostic accuracy was 80.30%,We grouped the OSCC and TIS as the tumor group, OLP, OLK with hyperplasia and inflammation as the non-tumor group, The sensitivity of DNA cytometry in diagnosing OSCC and TIS was 95.65%, and the specificity was 81.2%, The diagnostic accuracy was 85.28%. positive predictive values 66.67%, negative predictive values 97.94%, ratio odds 95, positive likelihood rat

关 键 词：DNA定量分析 口腔鳞状细胞癌 口腔潜在恶性疾病 口腔扁平苔藓 口腔白斑病 

分 类 号：R739.8[医药卫生—肿瘤]